常规微生物诊断的案例:在乌干达一家三级医院的创伤后伤口感染中进行抗微生物敏感性测试的结果
Laura Jung1, James Kiwanuka2, Leah Mbabazi3
1Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Leipzig University Medical Center, Leipzig, Germany.
PLOS global public health
|August 15, 2023
概括
乌干达的抗菌素耐药性 (AMR) 高,目前的伤口感染治疗无效. 超过95%的患者在抗生素敏感性测试后需要改变治疗方法,这凸显了需要更好的诊断和管理.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 公共卫生 公共卫生
背景情况:
- 抗菌素耐药性 (AMR) 是一个日益增长的全球健康威胁.
- 乌干达在诊断感染方面面临挑战,原因是对微生物诊断的获取有限.
- 创伤患者的伤口感染很常见,容易受到AMR的感染.
研究的目的:
- 在伤口感染中确定病原体流行和抗生素耐药性模式.
- 在乌干达坎帕拉评估经验性抗生素治疗的有效性.
- 为该地区打击AMR的战略提供信息.
主要方法:
- 在124名创伤患者中进行了前性观察性研究,这些患者患有伤口感染.
- 对抗微生物药物处方,伤口抹布和血液培养物的分析.
- 对细菌分离物进行的抗微生物敏感性测试 (AST).
主要成果:
- 包括大肠杆菌 (Escherichia coli) 和菌 (Acinetobacter spp.) 在内的阴性细菌是最常见的病原体.
- 观察到对常用的实证抗生素 (塞夫特里亚克松,珍塔米辛) 的高耐药率.
- 超过95%的患者需要根据AST结果修改治疗.
结论:
- 目前在坎帕拉治疗伤口感染的实证治疗在很大程度上是无效的,因为AMR率很高.
- 加强诊断能力和抗菌药物管理计划对于解决乌干达的抗菌耐药性至关重要.
- 需要紧急干预,以改善患者的治疗结果,并控制AMR的传播.
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